Impact of pre-transplant antiaggregant and anticoagulant therapies on early hemorrhagic and cardiovascular events after kidney transplantation

Journal of Nephrology
Claudio MusettiPiero Stratta

Abstract

Oral anticoagulation with vitamin K antagonists (VKA) and antiaggregant therapy (AAT) are common among dialysis patients, but it is not known if they increase the risk of hemorrhagic (HE) or cardiovascular events (CVE) in the early post-transplant weeks. We conducted a retrospective analysis on 911 consecutive kidney transplants (KTxs) in order to analyze the impact of AAT and VKA on early HE and CVE-which might be related to their withdrawal-and to identify the main risk factors for these complications. We observed 21/911 HE (2.3%; 1 death, 4 allograft loss); risk factors for HE at multivariate analysis were: KTx before 2004 (when anti-factor Xa activity measurement was not available; odds ratio, OR 5.835, [95% confidence interval, 1.241-27.436], p = 0.026), and VKA (OR 7.090 [2.030-24.772], p = 0.002), while AAT was not a risk factor. CVE were 32/911 (3.5%; 3 deaths, 11 allograft loss): risk factors for CVE at multivariate analysis were: previous cardiovascular events (OR 4.180 [1.615-10.948], p = 0.0032) and cinacalcet use (OR 7.930 [3.002-20.945], p < 0.0001), while neither VKA nor AAT had any impact. In conclusion, HE and CVE are relatively rare but can be severe, but there are no pre-KTx modifiable risk factors. If an ant...Continue Reading

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Citations

Feb 25, 2018·Current Urology Reports·Federico CicoraJavier Roberti
Dec 12, 2018·Transplant International : Official Journal of the European Society for Organ Transplantation·Tamar A J van den BergRobert A Pol
Apr 14, 2020·Materials Science & Engineering. C, Materials for Biological Applications·Quanchao ZhangHonglin Luo
Jan 12, 2021·Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie·M-O TimsitD M Smadja

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